Nokea
The Caucasian postpartum client asks the nurse if the stretch marks (striae gravidarum) on her abdomen will ever go away. Which response by the nurse is most accurate?
- A. “Your stretch marks should totally disappear over the next month.”
- B. “Your stretch marks will always appear raised and reddened.”
- C. “Your stretch marks will lighten in color with good skin hydration.”
- D. “Your stretch marks will fade to pale white over the next 3 to 6 months.”
Correct Answer: D
Rationale: Stretch marks will fade but will not totally disappear. Stretch marks will fade and will not always appear reddened. There is no evidence that keeping the skin hydrated will lighten the appearance of the stretch marks. In Caucasian women, stretch marks will fade to a pale white over 3 to 6 months.
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The postpartum client, who is 24 hours post—vaginal birth and breastfeeding, asks the nurse when she can begin exercising to regain her prepregnancy body shape. Which response by the nurse is correct?
- A. “Simple abdominal and pelvic exercises can begin right now.”
- B. “You will need to wait until after your 6-week postpartum checkup.”
- C. “Once your lochia has stopped, you can begin exercising.”
- D. “You should not exercise while you are breastfeeding.”
Correct Answer: A
Rationale: On the first postpartum day, the client should be taught to start abdominal breathing and pelvic rocking. Kegel exercises, which should have been taught during pregnancy, should be continued. Simple exercises should be added daily until, by 2 to 3 weeks postpartum, the mother should be able to do sit-ups and leg raises. Abdominal and pelvic exercises can begin right away and not wait for the 6-week postpartum checkup. There is no reason for the client to wait until the lochia has stopped before beginning exercises. There is no reason that a breastfeeding mother should not begin abdominal and pelvic exercises now.
Which advice can the nurse give to relieve the client's backache? Select all that apply.
- A. Avoid clothing that fits tightly around the waist.
- B. Sleep on a heating pad.
- C. Take a nonopioid pain reliever regularly.
- D. Wear low-heeled shoes.
- E. Carry objects close to your body.
- F. Squat when picking objects off the floor.
Correct Answer: A,D,E,F
Rationale: Tight clothing, high heels, and improper lifting exacerbate backaches; low-heeled shoes, proper lifting, and loose clothing help relieve strain.
The nurse notifies the HCP after feeling a pulsating mass during the vaginal examination of a newly admitted full-term pregnant client. Which HCP order should the nurse question?
- A. Prepare for possible cesarean section.
- B. Place the client in a knee-chest position.
- C. Initiate a low-dose oxytocin IV infusion.
- D. Give terbutaline 0.25 mg subcutaneously.
Correct Answer: C
Rationale: The nurse should question the administration of oxytocin (Pitocin). Oxytocin is used for stimulating contraction of the uterus. Uterine contractions can cause further umbilical cord compression. The pulsating mass indicates umbilical cord prolapse, which is a medical emergency. If vaginal birth is not imminent, a cesarean section is preferred in order to prevent hypoxic acidosis. Placing the client in a knee-chest position relieves pressure on the umbilical cord. Terbutaline (Brethine) is a tocolytic agent used to reduce contractions.
The nurse instructs the client to report which newborn symptom immediately?
- A. Mild jaundice on day 3
- B. Inability to suck or feed
- C. Occasional sneezing
- D. Soft spot on head
Correct Answer: B
Rationale: Inability to suck or feed is a serious symptom that may indicate neurological or health issues, requiring immediate reporting.
The postpartum client is being admitted for mastitis. The nurse should prepare the client for which interventions? Select all that apply.
- A. Walking at least four times in 24 hours
- B. Receiving a prescribed oral antibiotic
- C. Applying warm packs to the breasts
- D. Getting a prescribed anti-inflammatory drug
- E. Limiting oral fluid intake to 1000 mL per day
- F. Emptying the milk from her breasts frequently
Correct Answer: B,C,D,F
Rationale: Rest is important to promote healing. Bed rest may be initially prescribed for 24 hours. Treatment for mastitis includes administration of antibiotics to treat the infection. Application of warm packs decreases pain and promotes milk flow and breast emptying. Treatment for mastitis includes anti-inflammatory medications to treat fever and decrease breast inflammation. Increasing fluid intake to at least 2 to 3 liters is recommended, not limiting intake. If the breasts continue to be emptied by either breastfeeding or pumping, the duration of symptoms and the incidence of a breast abscess are decreased.